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Andreas Persson

Andreas Persson

Senior lecturer

Andreas Persson

Nationwide study of appendicitis in children


  • E. Omling
  • M. Salö
  • S. Saluja
  • S. Bergbrant
  • L. Olsson
  • A. Persson
  • J. Björk
  • L. Hagander

Summary, in English

Background: Paediatric surgical care is increasingly being centralized away from low-volume centres, and prehospital delay is considered a risk factor for more complicated appendicitis. The aim of this study was to determine the incidence of paediatric appendicitis in Sweden, and to assess whether distance to the hospital was a risk factor for complicated disease. Methods: A nationwide cohort study of all paediatric appendicitis cases in Sweden, 2001–2014, was undertaken, including incidence of disease in different population strata, with trends over time. The risk of complicated disease was determined by regression methods, with travel time as the primary exposure and individual-level socioeconomic determinants as independent variables. Results: Some 38 939 children with appendicitis were identified. Of these, 16·8 per cent had complicated disease, and the estimated risk of paediatric appendicitis by age 18 years was 2·5 per cent. Travel time to the treating hospital was not associated with complicated disease (adjusted odds ratio (OR) 1·00 (95 per cent c.i. 0·96 to 1·05) per 30-min increase; P = 0·934). Level of education (P = 0·177) and family income (P = 0·120) were not independently associated with increased risk of complicated disease. Parental unemployment (adjusted OR 1·17, 95 per cent c.i. 1·05 to 1·32; P = 0·006) and having parents born outside Sweden (1 parent born in Sweden: adjusted OR 1·12, 1·01 to 1·25; both parents born outside Sweden: adjusted OR 1·32, 1·18 to 1·47; P < 0·001) were associated with an increased risk of complicated appendicitis. Conclusion: Every sixth child diagnosed with appendicitis in Sweden has a more complicated course of disease. Geographical distance to the surgical facility was not a risk factor for complicated appendicitis.


  • Pediatric surgery
  • Centre for Geographical Information Systems (GIS Centre)
  • Dept of Physical Geography and Ecosystem Science
  • Surgery and public health
  • eSSENCE: The e-Science Collaboration
  • EpiHealth: Epidemiology for Health

Publishing year







British Journal of Surgery





Document type

Journal article


Oxford University Press


  • Public Health, Global Health, Social Medicine and Epidemiology



Research group

  • Pediatric surgery
  • Surgery and public health


  • ISSN: 0007-1323